Mon, 26 Nov 2018 09:17:22 -0500WeeblyThu, 21 Jun 2018 16:49:52 GMThttp://www.lactationlife.com/blog/becomeibclcWhen the Indigo Girls sing, “It took a long time to, become the thing I am to you” clearly they aren’t talking about studying to become an IBCLC, but it certainly applies. As parents go through their own breastfeeding journeys some realize they want to help other people as well. They often start out in Peer-to-peer support, such a vital resource for new families, and soon begin to think about increasing their knowledge and expertise by becoming an IBCLC. Since I did not start out as an RN, nor in a peer support organization, I often have inquiries from people who are interested in chatting with me about the process. Just in the past few months, several women have contacted me to chat so I thought it was the perfect time to write about the process of becoming an IBCLC for someone who is not an RN.

​The IBCLC (International Board Certified Lactation Consultant) title is conferred by IBLCE (the International Board of Lactation Consultant Examiners).

There are many blogs out there describing the various pathways to certification and, as always, it’s important to become completely familiar with the information provided by IBLCE. I’m going to focus on Pathway 3: Mentorship, as that is the route I took to certification. When people reach out to me for information, it is not so much for the facts and details, but rather the experience, the personal take on the journey.​The three criteria IBLCE lists are Health Sciences Education, Lactation Specific Education, and Lactation Specific Clinical Experience. Since the IBCLC exam is the last step, I will add that as the fourth component.

​Health Sciences Education - You will need to determine which courses you are missing based on your own college education. Eight of the courses must be for college credit; the other six may be continuing education.

​​​Thankfully I only needed to take two of the college courses: Human Biology and Nutrition. You can take them at any accredited higher institution, including community college, a local university, or through an online course. I found it easiest to take courses online since I was still working full-time. If you are looking to save money, I do recommend looking into your local community college; they are often less expensive than other colleges and universities.

The continuing education courses may also be taken at a college or university, but you can usually find them online for a better rate. I took mine from Health e-Learning, Lactation Education Resources, and a local CPR course provider. I am not endorsing any particular organization; there are other sources out there as well.

*Tip* Start gathering your transcripts early to ensure you have proof of all courses to fulfill the education requirement.

Lactation Specific Education - All IBCLC candidates, regardless of which Pathway they choose, are required to take at least 90 hours in lactation and breastfeeding education. IBLCE does not recommend specific courses, nor do they approve them in any way. It is your responsibility to be sure the course you take meets the requirements as outlined in the IBLCE Detailed Content Outline.

There are many courses available to you, in-person, online, or as a hybrid. Since I was not coming from a healthcare background, I wanted to have some in-person learning. I chose to go through Breastfeeding Outlook, which provided a hybrid version of the course. I liked that I could go at my own pace for the online seminars and then have a chance to ask questions in person. I asked a lot of questions! This particular course was originally designed for RNs already in the field and there were times that was clear to me, as they spoke in “nurse” language, which is why I needed to ask more questions than anticipated. I believe they received that feedback from other students as well and I’ve heard the course has shifted and it is more accessible to non-RNs now.

Lactation Specific Clinical Experience - Here’s the big one, guys - 500 hours of directly supervised clinical practice. This is the step that is most difficult for those not already working in L&D or as a peer counselor. Where can I get my hours? How will I get them while working full time? Do I need to leave my job? Can I do them part-time? How can my family afford it?

You can find your own mentor (and compensate that person(s) appropriately), or you can go through an organization that sets up mentorships for you, again for compensation. I bring up the compensation right away because many people go into this step thinking they can just find another IBCLC and work with them for free. Having a mentee takes extra time and commitment. If you find your own mentor, expect to create a contract, sign confidentiality agreements, and compensate that person.

I signed up with Lactation Education Resources for their 500-hour Clinical Internship Program. They took me through the steps of having my Pathway 3 plan approved, set up my clinical sites, worked with me to ensure I was gaining experience in a variety of lactation scenarios, and provided additional learning modules. I paid the fee to them and they compensated my mentors as appropriate. They were able to place me in clinical sites I would not have otherwise had access to, which included hospital-based, group private practice, and solo private practice. I believe I received a more thorough clinical education than I would have found on my own.

There are other companies that provide internship placements, so look for one in your area if that is the path you want to take.

​IBCLC Exam​It’s finally time for that final step to which you’ve been working! The IBCLC exam tests your knowledge in the Clinical Competencies set forth in the Detailed Content Outline.

They used to offer the exam once a year, in July. They now offer it twice a year, in April and October. I took the exam in April, so I needed to have my clinical hours completed by mid-November, the deadline for applying for the April exam. All dates are available on the IBLCE site.

There are a variety of practice test books as well as online tests. I highly recommend taking practice tests from at least two different providers. Linda Smith’s review book, Comprehensive Lactation Consultant Exam Review is highly regarded. I also took practice exams through Lactation Education Resources, Breastfeeding Outlook, and the online portion of the Breastfeeding and Human Lactation textbook. They were all different and helped me see where I needed to study and which areas were my strongest.

One week before the exam I stopped studying. I had taken my courses, completed my hours, and spent many months studying. I knew I needed to give my brain a chance to rest before the big exam.

I was nervous the day of the exam, but I also knew I had worked hard to get there and done everything I could to succeed. I didn’t want to say it at the time for fear of jinxing myself, but when I left the test, I felt good. There was nothing on the test that completely threw me for a loop. Yes, there were questions for which I couldn’t decide between two answers, or I wasn’t sure exactly what they were trying to get to, but it was all within expectations. I knew I got questions wrong, but I also felt I did well enough to pass. And then the waiting game...the test is in April, but the results do not come out until mid- to late-June (October to December for the other test window).

Well we know I passed, or I wouldn’t be writing this and working as an IBCLC! Even with my relative confidence that I passed, the wait was not easy. When my results finally came in the mail on June 17, I fell to the ground and cried. I’m not kidding! I felt so much relief after all the work I did, the chances I took, and the financial struggle I created for my family. I was an International Board Certified Lactation Consultant!

​

I’ll save the steps of setting up a private practice for another post. That has its own pitfalls and triumphs!

Hopefully I’ve given you some insight into the process of becoming an IBCLC through Pathway 3. Get to know the Pathway 3 Plan Guide well. Know all your requirements for education, for clinicals, for having your plan approved (you have to submit it to IBLCE), and all your dates. Don’t forget to keep track of all your education along the way in case you are audited. None of the steps are hidden, but you are responsible for keeping on top of all dates and requirements.​If you are thinking about becoming an IBCLC, what is your biggest concern?

]]>Fri, 13 Apr 2018 14:03:16 GMThttp://www.lactationlife.com/blog/breastfeedingonlineWe’ve all done it - we look to google for answers and information. The internet has provided us with the ability to access information more than any other generation. We have information and knowledge at our fingertips. But what if that information is incorrect? What if that information sends us down the wrong rabbit hole?

​Breastfeeding used to be a normal part of everyday life in a community; grandmothers, mothers, aunts, friends, all breasted around each other and learned from each other. We are physically more separated now, but the internet does provide a place we can ask questions and find answers. So where do we find accurate and helpful information?

I’ve gathered just a few of the websites where you can find helpful, trusted information about lactation and breastfeeding.

Kellymom.com - Kellymom is one of the top sites for evidence-based information. Kelly Bonyata, owner and creator of Kellymom, is an International Board Certified Lactation Consultant (IBCLC). Her articles help many families navigate issues and concerns and provide further references for follow through.

LactMed - Did you ever want to know how a certain medication might affect your milk supply or baby? From the National Library of Medicine at the National Institute of Health, you can search for both prescribed medications and over-the-counter products to determine whether or not they are safe to use while lactating.

AskDrSears.com - Dr. Sears and his team are well respected pediatric practitioners. Visit his site for understanding normal infant behavior and common issues associated with breastfeeding and parenting.

La Leche League International - La Leche League has been providing peer-to-peer support for over 60 years. Along with their in-person meetings, they have forums and online groups for breastfeeding information and support.

Breastfeeding Medicine of Northeast Ohio - This organization provides in-person appointments and support, but they also have online information and resources from experienced IBCLCs. They are well-known and respected for their therapeutic breast massage and hand expression.

Information garnered online can be helpful in handling minor issues, or even reassuring yourself everything is going well. Online education is not a substitute for an in-person consultation with an International Board Certified Lactation Consultant (IBCLC). Please reach out to an IBCLC in your community for assessment, evaluation, and care.

What online resources do you find most helpful for lactation and breastfeeding?

]]>Sun, 18 Mar 2018 19:01:55 GMThttp://www.lactationlife.com/blog/startingsolidsYou’ve made it through the first few weeks of breastfeeding, gotten into a groove over the next few months, possibly went back to work and handling the hectic schedule, and then you see it looming ahead - 6 months! Starting solids (also called complementary foods) is an exciting time, but it’s also another learning curve, for both you and baby.

​This roller coaster is what parenting is all about - just when you think you’ve got it all figured out, something changes...

Just like with any parenting task, there is more than one right way to introduce solid food to your baby. We all know about the lines of cute little baby food jars in the grocery stores. Some people choose to make their own baby food, and others use what is called Baby Led Weaning. We’ll briefly discuss these options here, but you will definitely want to read more about whichever method fits your parenting style.

Physical Readiness - Once your baby is 6 months old, s/he is ready to start complementary food when s/he is able to sit unassisted, hold his/her head up, and shows interest in your food.

Complementary Foods - Did you notice we’ve been saying complementary foods, along with solid foods? Solid foods in the first year of life are complementary to a baby’s main source of nutrition, which is breast milk (or breast milk substitute). That means breastfeeding, or breast milk by bottle, should come before foods during the meal. Babies are learning to eat solid foods, learning new tastes, and experiencing new textures of food. It is fun for them and an important developmental milestone, but it is not their main source of nutrition.

Baby Cereal- Baby cereal is not required! Most baby cereals are rice cereal and have very little nutritional value. You don’t have to feed your baby any cereal, but if you choose to, look for oatmeal or whole grains. Mix it with pumped breast milk for the best nutritional content.

Best First Foods - I know most of us think about starting with fruits and vegetables, but the nutrients a baby needs in the second half of his/her first year come from animal fats and proteins. Meats, avocado, and squash are good foods with which to start.

The Food - As previously mentioned, there is more than one way to feed your baby, and you don’t have to stick with just one way.

Pre-made baby food - Sold in grocery stores, they are easy to purchase and have ready when needed.

Homemade baby food - It’s easy to blend or mash up any food you want baby to have. You can make it in advance and freeze it in ice cube trays, or make it as you are making your own meal. You know exactly what your baby is eating, without extra preservatives added.

Baby Led Weaning - Let your children feed themselves! Baby led weaning allows your baby to learn how to handle different textures and sizes right from the start. This method has become very popular in recent years as families realize it is the normal way for humans to learn to eat, and control their own food intake. Be sure to read about it and watch videos so that you learn what babies can eat and how to do it.

Progression - From 6-12 months, your baby will begin eating more food, until they eventually eat three meals and a variety of snacks each day. When they are 12 months old, they will be eating everything the family does.

When your baby reaches 12 months or just beyond, they will probably be getting most of, or all, of their nutrients from their solid foods. You can continue breastfeeding and providing breast milk for as long as you both want. Breast milk continues to provide normal and optimal nutrition and immunities for your baby well beyond the first year of life.

But if you’re reading this post, you’re probably not at 12 months yet, so enjoy the next few months of your baby experiencing new foods - and making a mess!

]]>Sun, 14 Jan 2018 15:16:27 GMThttp://www.lactationlife.com/blog/trouble-with-a-bottleOhhhh, We’ve Got Trouble, My Friends, right here in River City! ...With a capital T and that rhymes with B and that stands for Bottle!

You’ve gotten breastfeeding off to a great start; baby is happy, healthy, and gaining well. You’re feeling great about your breastfeeding relationship and that awesome milk you provide. A couple months down the road you decide to give baby and bottle, and she refuses!

For some families, bottles are essential for when the nursing parent goes back to work. For others, it may not be needed every day, but parents want to have some time to run errands, go to appointments, spend time with friends, and be able to leave baby at home. So what do you if baby won’t take a bottle?

For this blog, I will focus on tips and tricks to giving a bottle to a baby who isn’t interested. These tips are not about introducing a bottle to a breastfed baby for the first time, paced bottle feeding, or which type of nipple/bottle to use. We will discuss those topics in future posts. You’ll notice that some of these tips contradict each other. All babies are different, just as their likes and dislikes vary, so what works for one baby may not work for another. Take some time to find what works for you and your baby.

Bottles & Milk

Use a small amount of milk when so that you don’t waste your precious pumped milk

Try slow-flow nipples since baby is more likely used to the slow flow of the breast

​Reverse CyclingSome babies choose not to take a bottle. For short periods of time, they may not need to have milk. For extended time, they may choose to go without milk when away from the breast, and get all their milk in the evening and overnight. This situation may not be ideal, and may be more tiring for the nursing parent, but fortunately baby is still getting all his nutrients and is happy during the day.

Take your timeYour baby cannot be forced into taking a bottle through hunger and persuasion. You may have to work on it over time. It’s ok to let baby play with the bottle and nipple in her mouth, getting used to the idea.

All of these tips are for babies refusing the bottle out of preference for feeding at the breast. If it seems your baby is struggling with a bottle for other reasons, please speak with an IBCLC or your pediatrician to rule out anatomical concerns. Some IBCLCs (including myself) do bottle consults to work with your baby and help you develop a plan for guiding your baby towards taking a bottle. Bottle refusal is yet another time you are not alone. Always reach out for help.

I’ve also included this information in the attached PDF for easy printing and reference.

​The holidays are upon us. The errand-running, food-making, family-gathering busy season. It can feel joyous and special, even among the craziness of it all. When you have a nursing baby, especially a newborn, the excitement grows even more. Family wants to see the baby, give gifts, and be a part of this special time. The busy holiday season can also be a challenge for new parents as you navigate time with the baby, breastfeeding, and keeping away sickness. I’ve collected some of the best tips for maintaining your breastfeeding relationship, keeping baby fed, and maintaining your supply during the holiday season.​

You are the Parent - As we spend time with family, many well-meaning family members give advice and offer to care for the baby. Take them up on it if it fits your parenting style, but remember you are the parent. Some people may suggest things that don’t feel right to you, and it’s ok to politely decline, or nod and smile, and then continue doing what you are doing.

Set a Timer - Normally I recommend watching the baby and following his/her cues, rather than watching a clock, however during the holidays time can get away from us. If you are running errands or travelling, your baby may fall into a lulled sleep and may not show you signs of hunger. The same may happen in a swing during a holiday celebration, or when being passed around from family member to family member. Set a timer on your phone to remind you to feed the baby. (Your breasts may also serve as a natural timer when they start to feel full).

Keep Baby Healthy - Most people nowadays are cognizant of passing germs to babies, but you may want to be proactive. Don’t be afraid to ask people to wash their hands, use hand sanitizer, or not kiss the baby. While we want babies to build a strong immune system, newborns are more susceptible to germs. It’s a good thing you are providing them with all those strong antibodies through your breast milk!

Wear Your Baby - Use a wrap or carrier to keep your baby close. It will help keep baby calm, you can easily respond to his/her hunger cues, it’s an easy place for a nap, and it’s a polite way to keep many hands away in case of sickness.

Take Time Away - Nursing a baby is the perfect reason to excuse yourself and spend some quiet time with your baby in another room. Holidays can be overwhelming even for adults, and as a new parent, you may need a few minutes to rest quietly and breath. All of the activity may also over-stimulate your baby and s/he may need some quiet time with you.

Nurse Where You Want To - Although the previous tip mentioned moving to another room, remember that it’s also okay to nurse where you are most comfortable. If you don’t want to miss anything, find a comfortable spot amid the group and nurse your baby. Breastfeeding is a normal part of you and your baby’s life, and you have every right to nurse your baby where you see fit.

Accept Help - Hopefully with family and friends around, people will be willing to help. Don’t be afraid to tell them what you really need - hold the baby while you take a shower, or let you have time with your baby while they change the laundry or load the dishwasher. Most people want to do something truly helpful and will appreciate your candor.

Enjoy a Drink - It’s okay to drink alcohol while you are breastfeeding. It stays in the breast milk a similar amount of time it stays in your blood. A great time to have a drink is right before, or while you are breastfeeding. It takes a bit of time to get into the milk, and then by the time baby is hungry again, it will have dissipated. Don’t be afraid to enjoy a drink during the holidays.

In the end, the most important tip is to treasure the holidays and this time with your little one. I know it can feel overwhelming, especially if you are struggling with breastfeeding or the postpartum period. Take a moment to breathe and know you have created this little being, or you brought him/her into your home to love. Through breastfeeding, you are sustaining your baby’s life and giving him/her all s/he needs. That is something to celebrate!